2nd failed Tympanoplsty - What do I do?

[acshaw80]

Here's the story:

I've always had eustachian tube dysfunction since I was a child.  In my mid 20's I decided to go to a ENT and ask if there was anything thing that could be done as its very annoying to have to constantly be popping my ears.  He decided the best option was to put a tube in my right ear which ends up being a terrible mistake because 5 years later a different ENT will tell me I still have the hole in my ear.  I was then told that I needed to have it repaired because it would help with the very slight hearing loss I have and also prevent cholesteotomas from developing (which, I was told, can cause facilal paralysis or lead to infections that may cause death).  I then meet with a surgeon at the Cleveland Clinic who decided to perform a tympanoplasty using (I believe) muscle tissue to patch my broken ear drum.

I was told after about two months of post surgical doctor visits that graft had failed and that the hole was about 30-40% of my ear drum. I also experienced significant hearing loss in that ear.  I would say about a 50% loss which for all intents and purposes still exists today.  Its been about two years and I've only recovered a small portion of that initial hearing loss.  

I decided to go to another doctor, this time at University Hospitals here in Cleveland.  This doctor indicated that he could help fix my hearing while performing a second tympanoplasty.  This surgery was performed in November of 2012 and up until today, May 23, 2013 the surgery was considered successful in that the graft had taken (this time cartilage was used for the graft instead of muscle tissue).  This surgery improved my hearing by about 5-10%, but I still have that significant hearing loss in my right ear. The doctor informed me in March that the graft looked great and that I could swim and lift weights.  I should also push gently on my ear drums to help clear out any fluid that may still be in them which might improve my hearing.  I am to do this about 10x per day until I see him for our next appointment in mid June.  Today, while doing this exercise I pushed air through my ear drum.  I tested it a second time to make sure that I wasn't mistaken and had the same results.  It's my belief that pushing on the ear drum in this way may have weakened it and caused the failure.

At any rate, I'm left asking myself what in the heck I am supposed to do? Why would the 2nd tympanoplasty have failed after it looked so promising? Do I continue having tympanoplastys until one actually works?  Is there any real fear of a cholesteotoma forming if I don't have my ear repaired?  Is there any real good reason why I shouldn't just leave the hole in my ear?  Head surgery is not fun and I'm tired of spending the money on surgeries that don't work for me.  Any thoughts?

[Paderla Anitha, DNB]

Good Luck

[acshaw80]

No, the eustachian tube dysfunction was not resolved.  A tube was put in my ear drum to try and resolve the issue, but it did not. I'm left dealing with the side effects of having a tube put in my ear drum (and the ear drum not repairing itself).  My hearing loss occurred after the surgery (despite having a hole in my ear drum, my hearing was normal) so it would be my guess that the ossicles were fine at least up until the first surgery.  I have an appointment with my ENT on June 6th and will post an update.  Thank you for your reply.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

I don't understand, has the eustachian tube dysfunction resolved now? The out come with tympanoplasty for hearing loss depends on the status of the ossicles (ear bones). And according to studies done, with revision tympanoplasty, mastoidectomy is associated with a better functional outcome. The hole in the tympanic membrane besides causing hearing loss can promote middle ear infections and sometimes a cholesteatoma formation, which can also damage the middle ear. So, its best to have it repaired.

Hope this helped and do keep us posted.